There are many stories of patients being misdiagnosed and given treatment for asthma when in fact years later the patient is then diagnosed with COPD.
Pat Crowe was a healthy, active 39 year old but was told he had developed asthma and was given an inhaler. Over the next few years his health deteriorated, he grew dependent upon and overused his inhaler, suffered from side effects and eventually the inhaler wasn’t enough. Being so breathless meant his confidence plummeted, making him almost housebound.
‘I panicked about going outside and crossing busy roads because I was having trouble breathing and couldn’t move quickly.’
During bad spells and prolonged attacks he was also prescribed strong steroid pills, which caused side-effects, including a swollen face and hunger.
‘My wife became my carer, and my family were very scared watching me struggle to breathe,’ he says. ‘I didn’t even want to get out of bed and go down stairs because I was worried about getting back up. My life changed completely.’
It was only then that Pat’s consultant performed a spirometer test which confirmed that he didn’t have asthma after all but suffered from COPD, which explained why he’d found the condition impossible to control.
COPD is incurable and affects 900,000 people in the UK, usually above the age of 35, and an estimated 30,000 people die from it each year. Experts believe there are also more than two million undiagnosed cases.
Specialist advice is crucial when it comes to achieving an accurate diagnosis says Dr Kurukulaaratchy: ‘GPs need better awareness of these conditions. They both rank highly in hospital admissions, but if management is right early on, you can improve quality of life and possibly even life expectancy.’
Nick Hopkinson, honorary chest physician at the Royal Brompton Hospital, London, adds: ‘Asthma patients usually have normal lung function, but when they experience asthma symptoms or an attack their airways go into spasm, becoming narrow and inflamed. Then, after taking medication – usually an inhaler – their lungs return to normal. However, COPD patients have relatively fixed lung disease, so even on a good day they still have symptoms. Most of the damage isn’t reversible and progressively worsens.’
One major consequence of misdiagnosis is that patients could be given the wrong medication.
COPD patients usually start with bronchodilator inhalers to relieve narrowing of the airways and then go through a variety of drugs, starting with shorter-acting medications and moving to longer-acting ones, as the disease worsens, says Dr Kurukulaaratchy.
‘Research has shown steroids can lead to an increased risk of pneumonia (inflammation of lung tissue) in COPD patients, so this is a risk if they are wrongly labelled as having asthma.’
If the condition doesn’t improve, they can end up using a lot of steroids, which have side-effects such as weight gain, mood changes and osteoporosis.
‘If patients are told they have COPD but it’s asthma and they don’t have inhaled steroids, they won’t be able to control the disease – leaving them prone to worsening symptoms and even death from an asthma attack,’ says Dr Hopkinson. ‘We see 1,100 asthma deaths a year in the UK, often because they weren’t on preventer treatments.’
Also oxygen therapy treatment is a major component of COPD treatment which is prescribed by your doctor, so if you are misdiagnosed then you may not be prescribed oxygen as early as you should have been which can affect your health and long-term diagnosis as COPD damage to the lungs is irreversible.
If you have any doubts about your diagnosis then speak to your doctor or get a second opinion, just to be sure as your health is the most important thing.